Viral load spike 3 weeks after stopping Maraviroc

Mar 16, 2013

Hello, I have been on a regimen of Truvata, Isentress, and Selzentry. I recently convinced my doctor to drop the Selzentry since no drastic CD4 increases were seen, as later studies confirmed. However, after getting my viral load tested 3 weeks after stopping Selzentry, it is no longer undetectable, but has gone up to 96. What should I do? If I had some type of resistance to Truvata or Isentress that was masked by the Selzentry, I'm afraid that by waiting I could end up with resistance to both Isentress and one or more ingredients in Truvata. Do you recommend a viral load retest sooner than my scheduled retest in six weeks, and if so, how soon? Thanks for your help.

Response from Dr. Young

Hello and thanks for posting.

A single viral load of 96 could be the result of many things- including anything that causes activation of the immune system, like a cold, sinus infection, cold sore, or recent vaccination. An occasional lab error also will result in low-level detectability (especially with today's ultrasensitive tests). Of course, this 96 could be an early harbinger of treatment breakthrough, but I'd rather doubt it.

Either way, a repeat viral load test would be a reasonable way to check- there's no specific timeline for doing this, other than probably not to do the test too soon (particularly if there's any concern with that immune activation/infection thing). Usually I will offer a repeat test in 2-6 weeks.

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